platelet rich fibrin | Acta Medica Marisiensis

Comparative clinical evaluation of xenograft (Cerabone) versus allograft combined with platelet-rich fibrin for treatment of grade II mandibular furcation defects

Suhina Mitra¹, Deepa G. Kamath¹, Nishmitha D. Shetty¹, Srikanth N²

1. Department of Periodontology, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 575001, India
2. Department of Oral Pathology, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 575001, India

DOI: 10.2478/amma-2023-0016

Aim: The present study aims to evaluate the efficacy of naturally-derived bovine hydroxyapatite (Cerabone) versus demineralized freeze-dried bone allograft both combined with platelet-rich fibrin for treatment of grade II mandibular furcation defects.
Method: This clinical study included 20 systemically healthy patients, with grade II mandibular furcation defects, performed over 6 months. Control group comprised of open flap debridement + demineralized freeze-dried bone allograft + platelet-rich fibrin and test group comprised of open flap debridement + Cerabone + platelet-rich fibrin. Clinical parameters included: Plaque index, Modified Sulcular bleeding index, Vertical probing pocket depth, Horizontal probing depth, Probing clinical attachment level, Radiographic furcation depth, and radiographic bone fill percentage.
Results: Both groups showed satisfactory bone regeneration and improvement in clinical parameters. The test group exhibited greater reduction in vertical probing pocket depth, horizontal probing depth, and higher radiographic bone fill percentage when compared to control group, although these findings were not statistically significant.
Conclusion: Both bone grafts were equally effective in treatment of grade II furcation defects. Further long-term studies are required to explore their maximum regenerative potential.

Maturogenesis of an immature necrotic tooth with an extensive perirapical lesion using platelet rich fibrin

Bhaswati Chakraborty¹, Ashwin Rao²

1. Department of Dentistry, Calcutta National Medical College and Hospital, West Bengal University of Health Sciences, Kolkata, West Bengal, India
2. Department of Paediatric and Preventive Dentistry, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India

DOI: 10.2478/amma-2022-0001

Introduction: Earlier, treatment of immature necrotic tooth focussed only on surgical endodontic management and apexification procedures. Regenerative endodontic therapies have called for a paradigm shift in management of such cases. Prognosis becomes challenging though at times due to chronicity of infection, inadequate disinfection of canal space and cytotoxic nature of irrigants used hindering the survival of the apical stem cells.
Case presentation: This report highlights the management of a long-standing case of an immature necrotic tooth with an extensive periapical lesion in a 12 year old male patient. The protocol of regenerative endodontic procedure using platelet rich fibrin (PRF) was followed. Follow up visits at 1week, 3months and 12 months revealed a successful clinical and radiological outcome leading to progressive maturogenesis of the tooth.
Conclusion: The case report favours the possibility of stem cells of apical papilla being viable even in chronic periapical lesions. Hence conservative approach involving regenerative endodontic therapies should always be sought for as first line of treatment in such cases.